Chronic Myeloid Leukemia (CML): Stories of Hope - Decisions on Cancer Care

Contributed by: Dr Lee Yuh Shan

When David experienced unexplained ankle pain throughout the first half of 2019, he brushed it off as an unexplained incident. After it came a second and third time, along with frequent fevers and persistent sore throats, he decided to seek medical help.

It was then that he discovered he had Chronic Myeloid Leukemia (CML).

  • CML is a cancer of the bone marrow and white blood cells. It is a form of leukemia that is characterised by an increased growth of myeloid cells in the bone marrow and the accumulation of these cells in the blood.
  • Like many cancers, CML may not show symptoms in its early stages. Some tell-tale signs of CML may include bone pain or swelling at the side of the rib cage when the leukemia cells progress and spread.

Fortunately for David, his CML was treatable.

“The first thing I did was to call my wife and tell her the news,” shared David. “There was no crying over the phone because I was reassured by my doctor that it was treatable.”

For three months, David underwent a course of treatment that included targeted therapy to control his CML. However, when his ankle pain returned, David found out his CML had transformed into Acute Lymphoblastic Leukemia (ALL), which is characterised by the rapidly progressive growth and accumulation of immature lymphocytes. This was due to a special mutation in the gene driving the CML, making the targeted therapy less effective.

“I was told that the targeted therapy I had been receiving thus far for CML had not been developed far enough for acute leukemia such as ALL,” David explained. “Because of that, I was recommended a bone marrow transplant as a treatment course for long-term survival.”

Facing the odds of survival

David’s biggest concern when he processed the news was the odds of survival. “At the back of my mind, the only knowledge I have of cancer treatment is nausea and hair loss. ‘Will I no longer be a human being?’—that was the image I had. But my doctor told me it was humanly doable and humanly survivable.

“When you get hit by such a diagnosis, your priority changes. There was no thinking of money or work. The decision for treatment is the first decision you make. Any other decisions are influenced by that first decision.”

Thankfully for David, his insurance took care of the bulk of his financial concerns. Without having to worry about funding for his treatment, David was able to focus on getting well.

Cancer care in a time of covid-19

However, a different challenge came in early 2020 when the world was hit with the global COVID-19 pandemic and saw city-wide lockdowns. For vulnerable patients like David, the situation caused minor inconveniences in his cancer treatment journey.

“When you hear about the supermarkets and pharmacies running out of household supplies such as toilet paper and hand sanitisers, we as patients are doubly worried. Without these supplies, we may catch an infection and that may have sent us back to the hospital in no time.”

  • “Patients who have just undergone a bone marrow transplant have weakened immunity and are more susceptible to viruses and infections,” commented Dr Lee Yuh Shan, Senior Consultant, Haematology.

COVID-19 also had a social and psychological impact on David’s mental health during his posttreatment recovery. “With everyone at home, there was no longer any outside entertainment to keep me occupied,” shares David. “So for the first few months, it was mentally difficult because all that came to a stop.

For David, acceptance is key to managing the physical, psychological and emotional turmoil that patients with cancer face.

“When I was reading about leukemia, I found one quote that changed my mindset,” shares David. “It says, ‘The sooner you accept wholeheartedly that your life will never go back to the way it was before, the happier you will be.’

“There are a lot of big life-changers from diagnosis. If you keep thinking about the past, or if you keep thinking about the future, you will be unhappy.

“If I could tell myself back then what to do, it’d be to not let anything get to you because we’ve only got one body. We’ve only got one life, one health. So we have to treasure that.”

POSTED IN Covid-19, Up Close and Personal
TAGS cancer diagnosis, cancer quality of life, leukemia, targeted therapy
READ MORE ABOUT Acute Lymphoblastic Leukaemia (ALL) in Adults, Chronic Myeloid Leukaemia (CML)